ABSTRACT After thirty-two years since the first domestic outbreak of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)among injection drug users(IDUs)and almost two decades of comprehensive r...ABSTRACT After thirty-two years since the first domestic outbreak of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)among injection drug users(IDUs)and almost two decades of comprehensive response efforts by the Chinese government,HIV/AIDS remains a major public health problem.The increasing burden of HIV/AIDS and comorbidities,the emergence of new HIV subtypes and/or circulating recombinant forms and drug mutations,the changing transmission networks.展开更多
In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the workingage population.In the next 15 years,the number o...In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the workingage population.In the next 15 years,the number of patients suffering from diabetes mellitus is expected to increase significantly.By the year 2030,about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide(prevalence 7.7%),while in 2010 there were 285 million people with diabetes mellitus(prevalence 6.4%).This accounts for an increase in patients with diabetes in industrializednations by 20% and in developing countries by 69% until the year 2030.Due to the expected rise in diabetic patients,the need for ophthalmic care of patients(i.e.,exams and treatments) will also increase and represents a challenge for eye-care providers.Development of optimized screening programs,which respect available resources of the ophthalmic infrastructure,will become even more important.Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy.Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels.Additionally,regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy.In this way,the risk of blindness can considerably be reduced.In advanced stages of diabetic retinopathy,pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment.In recent years,the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.展开更多
目的:系统评价注射用阿奇霉素治疗小儿支原体肺炎的疗效与安全性,为其临床应用提供循证依据。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane图书馆,纳入注射用阿奇霉素(试验组)对比其他药物...目的:系统评价注射用阿奇霉素治疗小儿支原体肺炎的疗效与安全性,为其临床应用提供循证依据。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane图书馆,纳入注射用阿奇霉素(试验组)对比其他药物(对照组)治疗小儿支原体肺炎的随机对照试验(RCT),提取资料并按Cochrane系统评价员手册5.2.0评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:最终纳入20项RCT,包括1 793例患儿,对照组均采用红霉素进行治疗。Meta分析结果显示,试验组患儿的总有效率[RR=1.13,95%CI(1.06,1.20),P<0.001]、退热时间[MD=-1.03,95%CI(-1.43,-0.64),P<0.001]、咳嗽好转时间[MD=-2.34,95%CI(-3.13,-1.55),P<0.001]、肺部啰音消失时间[MD=-2.54,95%CI(-4.37,-0.70),P=0.007]、胸片阴影吸收时间[MD=-1.76,95%CI(-3.43,-0.09),P=0.04]、住院时间[MD=-2.72,95%CI(-3.50,-1.94),P<0.001]均优于对照组;且总不良反应发生率[RR=0.39,95%CI(0.31,0.49),P<0.001]、胃肠道反应发生率[RR=0.36,95%CI(0.28,0.47),P<0.001]、肝脏毒性发生率[RR=0.55,95%CI(0.34,0.89),P=0.01]、输液反应发生率[RR=0.31,95%CI(0.20,0.48),P<0.001]、皮疹发生率[RR=0.34,95%CI(0.20,0.59),P<0.001]、腹痛发生率[RR=0.21,95%CI(0.09,0.49),P<0.001]等均显著低于对照组。结论:注射用阿奇霉素用于治疗小儿支原体肺炎具有良好的疗效与安全性。展开更多
AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl for treatment of gastric variceal bleeding and prophylaxis.METHODS:Between January 1994 and March 2010 at SoonChunHyang Uni...AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl for treatment of gastric variceal bleeding and prophylaxis.METHODS:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl injections endoscopically.One hundred patients underwent endoscopic Histoacryl injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic procedure.RESULTS:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were IGV.Most of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl injection as a primary prophylactic procedure.In these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of patients.Successful hemostasis during episodes of rebleeding was achieved in 73.9%of cases.Median survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other conditions.None of the 27 subjects who were treated prophylactically experienced treatment-related complications.Cumulative survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,respectively.The 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which carry high risk of bleeding.展开更多
In the Sichuan Basin,seismic activity has been low historically,but in the past few decades,a series of moderate to strong earthquakes have occurred.Especially since 2015,earthquake activity has seen an unprecedented ...In the Sichuan Basin,seismic activity has been low historically,but in the past few decades,a series of moderate to strong earthquakes have occurred.Especially since 2015,earthquake activity has seen an unprecedented continuous growth trend,and the magnitude of events is increasing.Following the M5.7 Xingwen earthquake on 18 Dec.2018,which was suggested to be induced by shale gas hydraulic fracturing,a swarm of earthquakes with a maximum magnitude up to M6.0 struck Changning and the surrounding counties.Questions arose about the possible involvement of industrial actions in these destructive events.In fact,underground fluid injection in salt mine fields has been occurring in the Sichuan Basin for more than70 years.Disposal of wastewater in natural gas fields has also continued for about 40 years.Since 2008,injection for shale gas development in the southern Sichuan Basin has increased rapidly.The possible link between the increasing seismicity and increasing injection activity is an important issue.Although surrounded by seismically active zones to the southwest and northwest,the Sichuan Basin is a rather stable region with a wide range of geological settings.First,we present a brief review of earthquakes of magnitude 5 or higher since 1600 to obtain the long-term event rate and explore the possible link between the rapidly increasing trend of seismic activity and industrial injection activities in recent decades.Second,based on a review of previous research results,combined with the latest data,we describe a comprehensive analysis of the characteristics and occurrence conditions of natural and injection-induced major seismic clusters in the Sichuan Basin since 1700.Finally,we list some conclusions and insights,which provide a better understanding of why damaging events occur so that they can either be avoided or mitigated,point out scientific questions that need urgent research,and propose a general framework based on geomechanics for assessment and management of earthquake-related risks.展开更多
基金Supported by Shanghai Municipal Health Commission(GWV-10.1-XK16)the National Natural Science Foundation of China(82173579,81773485)Yiwu Research Institute of Fudan University.
文摘ABSTRACT After thirty-two years since the first domestic outbreak of human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)among injection drug users(IDUs)and almost two decades of comprehensive response efforts by the Chinese government,HIV/AIDS remains a major public health problem.The increasing burden of HIV/AIDS and comorbidities,the emergence of new HIV subtypes and/or circulating recombinant forms and drug mutations,the changing transmission networks.
文摘In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the workingage population.In the next 15 years,the number of patients suffering from diabetes mellitus is expected to increase significantly.By the year 2030,about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide(prevalence 7.7%),while in 2010 there were 285 million people with diabetes mellitus(prevalence 6.4%).This accounts for an increase in patients with diabetes in industrializednations by 20% and in developing countries by 69% until the year 2030.Due to the expected rise in diabetic patients,the need for ophthalmic care of patients(i.e.,exams and treatments) will also increase and represents a challenge for eye-care providers.Development of optimized screening programs,which respect available resources of the ophthalmic infrastructure,will become even more important.Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy.Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels.Additionally,regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy.In this way,the risk of blindness can considerably be reduced.In advanced stages of diabetic retinopathy,pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment.In recent years,the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.
文摘目的:系统评价注射用阿奇霉素治疗小儿支原体肺炎的疗效与安全性,为其临床应用提供循证依据。方法:计算机检索中国知网、万方数据库、中国生物医学文献数据库、PubMed、Embase、Cochrane图书馆,纳入注射用阿奇霉素(试验组)对比其他药物(对照组)治疗小儿支原体肺炎的随机对照试验(RCT),提取资料并按Cochrane系统评价员手册5.2.0评价质量后,采用Rev Man 5.3统计软件进行Meta分析。结果:最终纳入20项RCT,包括1 793例患儿,对照组均采用红霉素进行治疗。Meta分析结果显示,试验组患儿的总有效率[RR=1.13,95%CI(1.06,1.20),P<0.001]、退热时间[MD=-1.03,95%CI(-1.43,-0.64),P<0.001]、咳嗽好转时间[MD=-2.34,95%CI(-3.13,-1.55),P<0.001]、肺部啰音消失时间[MD=-2.54,95%CI(-4.37,-0.70),P=0.007]、胸片阴影吸收时间[MD=-1.76,95%CI(-3.43,-0.09),P=0.04]、住院时间[MD=-2.72,95%CI(-3.50,-1.94),P<0.001]均优于对照组;且总不良反应发生率[RR=0.39,95%CI(0.31,0.49),P<0.001]、胃肠道反应发生率[RR=0.36,95%CI(0.28,0.47),P<0.001]、肝脏毒性发生率[RR=0.55,95%CI(0.34,0.89),P=0.01]、输液反应发生率[RR=0.31,95%CI(0.20,0.48),P<0.001]、皮疹发生率[RR=0.34,95%CI(0.20,0.59),P<0.001]、腹痛发生率[RR=0.21,95%CI(0.09,0.49),P<0.001]等均显著低于对照组。结论:注射用阿奇霉素用于治疗小儿支原体肺炎具有良好的疗效与安全性。
文摘AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl for treatment of gastric variceal bleeding and prophylaxis.METHODS:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl injections endoscopically.One hundred patients underwent endoscopic Histoacryl injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic procedure.RESULTS:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were IGV.Most of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl injection as a primary prophylactic procedure.In these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of patients.Successful hemostasis during episodes of rebleeding was achieved in 73.9%of cases.Median survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other conditions.None of the 27 subjects who were treated prophylactically experienced treatment-related complications.Cumulative survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,respectively.The 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which carry high risk of bleeding.
基金support of the State Scholarship Fund of China(Grant No.201804190004)。
文摘In the Sichuan Basin,seismic activity has been low historically,but in the past few decades,a series of moderate to strong earthquakes have occurred.Especially since 2015,earthquake activity has seen an unprecedented continuous growth trend,and the magnitude of events is increasing.Following the M5.7 Xingwen earthquake on 18 Dec.2018,which was suggested to be induced by shale gas hydraulic fracturing,a swarm of earthquakes with a maximum magnitude up to M6.0 struck Changning and the surrounding counties.Questions arose about the possible involvement of industrial actions in these destructive events.In fact,underground fluid injection in salt mine fields has been occurring in the Sichuan Basin for more than70 years.Disposal of wastewater in natural gas fields has also continued for about 40 years.Since 2008,injection for shale gas development in the southern Sichuan Basin has increased rapidly.The possible link between the increasing seismicity and increasing injection activity is an important issue.Although surrounded by seismically active zones to the southwest and northwest,the Sichuan Basin is a rather stable region with a wide range of geological settings.First,we present a brief review of earthquakes of magnitude 5 or higher since 1600 to obtain the long-term event rate and explore the possible link between the rapidly increasing trend of seismic activity and industrial injection activities in recent decades.Second,based on a review of previous research results,combined with the latest data,we describe a comprehensive analysis of the characteristics and occurrence conditions of natural and injection-induced major seismic clusters in the Sichuan Basin since 1700.Finally,we list some conclusions and insights,which provide a better understanding of why damaging events occur so that they can either be avoided or mitigated,point out scientific questions that need urgent research,and propose a general framework based on geomechanics for assessment and management of earthquake-related risks.
